Does the tendency to act impulsively underlie binge eating and alcohol use problems? An empirical investigation

The co-occurrence of problem drinking and binge eating and purging has been well documented. However, there has been relatively little investigation of etiological models that may influence the development of this  co-occurrence. This study tests the hypotheses that impulsivity is heightened in eating disordered women compared with controls, and that women with comorbid bulimia and alcohol use disorders show higher impulsivity than bulimic-only women. The Impulsivity scale, BIS/BAS scales, State Anxiety Inventory, and a behavioural measure of reward responsiveness (CARROT) were administered to 22 women with bulimia, 23 women with comorbid bulimia and alcohol abuse/dependence, and 21 control women. As hypothesised, eating disordered women scored higher than controls on several self-report measures of impulsivity and sorted cards faster during a financially rewarded trial on the behavioural task. Also, as predicted, comorbid women scored higher than bulimic women on the Impulsivity scale. These findings suggest that individual differences in impulsiveness and a tendency to approach rewarding stimuli may contribute to developing these disorders.

Rural parents, teenagers and alcohol: what are parents thinking?

INTRODUCTION: The fundamental role of alcohol in the lives of young Australians is mirrored in the level of drinking by adolescents. In 2001, more than one in four Australian adolescents aged 14-19 years consumed alcohol weekly. Teenagers in rural areas are more likely to consume alcohol than their metropolitan counterparts. Parents are key 'gatekeepers' of adolescent behaviour and as such are a salient group to consider in relation to adolescent alcohol use. The aim of this study was to explore parents' attitudes, beliefs, concerns and receptiveness to harm minimisation strategies with respect to teenage use of alcohol.

METHODS: A convenience sample of parents with adolescent children attended a series of focus groups across the north and north-western area of the State of Victoria, Australia. Schools were approached to advertise the project and invite parents to participate. Snowball sampling was used to enhance recruitment.

RESULTS: Parents described patterns of alcohol use such as 'drinking to get drunk' and the influence of both parents and peers on the consumption of alcohol by adolescents. Few parents were concerned about the long-term risks of alcohol use by teenagers; rather they were more concerned about the short-term harms, for example, road trauma and other accidents and risky behaviours such as binge drinking. Parents indicated that they perceived alcohol to be less harmful than other drugs and many indicated that alcohol was often not perceived to be a drug. A number of strategies were adopted by parents to negotiate teenagers' drinking and to minimise the risks associated with alcohol use. These included transporting teenagers to parties, providing teenagers with a mobile phone, setting clear guidelines about alcohol use and/or providing teenagers with a small amount of alcohol. These were seen by parents as strategies for reducing the risks associated with alcohol consumption. Many parents reported that they do not feel well informed about alcohol use and how and when to use harm reduction strategies.

CONCLUSIONS: Rural parents are unsure how to respond to teenagers' alcohol use and drunkenness. While some parental strategies for harm reduction (such as supplying adolescents with a small amount of alcohol) may have good face validity in reducing alcohol consumption among adolescents, these strategies are not supported by previous research findings.

Prediction of alcohol-related harm from controlled drinking stragegies and alcohol consumption trajectories

Aims To establish predictors of age 21 alcohol-related harm from prior drinking patterns, current levels of alcohol consumption and use of controlled drinking strategies.
Participants One thousand, five hundred and ninety-six students recruited from an initial sample of 3300 during their final year of high school in 1993.
Design Longitudinal follow-up across five waves of data collection.
Setting Post high school in Victoria, Australia.
Measurements Self-administered surveys examining a range of health behaviours, including alcohol consumption patterns and related behaviour.
Findings Drinking behaviours at age 21 were found to be strongly predicted by drinking trajectories established through the transition from high school. Multivariate regression analysis revealed that alcohol-related harms at age 21 were reduced where current levels of alcohol use fell within limits recommended in Australian national guidelines. After controlling for this effect it was found that the range of strategies employed by participants to control alcohol use maintained a small protective influence. Post-high-school drinking trajectories continued to demonstrate a significant effect after controlling for current behaviours. Findings revealed that over one quarter of males and females drank alcohol, but on a less-than-weekly basis. This pattern of alcohol use demonstrated considerable stability through the post-school transition and was associated with a low level of subsequent harm at age 21.
Conclusions Future research should investigate whether encouraging more Australian adolescents to drink alcohol on a less-than-weekly basis may be a practical intervention target for reducing alcohol-related harms.

Prediction of alcohol-related harm from controlled drinking strategies and alcohol consumption trajectories

Aims To establish predictors of age 21 alcohol-related harm from prior drinking patterns, current levels of alcohol consumption and use of controlled drinking strategies.

Participants One thousand, five hundred and ninety-six students recruited from an initial sample of 3300 during their final year of high school in 1993.

Design Longitudinal follow-up across five waves of data collection.

Setting Post high school in Victoria, Australia.

Measurements Self-administered surveys examining a range of health behaviours, including alcohol consumption patterns and related behaviour.

Findings Drinking behaviours at age 21 were found to be strongly predicted by drinking trajectories established through the transition from high school. Multivariate regression analysis revealed that alcohol-related harms at age 21 were reduced where current levels of alcohol use fell within limits recommended in Australian national guidelines. After controlling for this effect it was found that the range of strategies employed by participants to control alcohol use maintained a small protective influence. Post-high-school drinking trajectories continued to demonstrate a significant effect after controlling for current behaviours. Findings revealed that over one quarter of males and females drank alcohol, but on a less-than-weekly basis. This pattern of alcohol use demonstrated considerable stability through the post-school transition and was associated with a low level of subsequent harm at age 21.

Conclusions Future research should investigate whether encouraging more Australian adolescents to drink alcohol on a less-than-weekly basis may be a practical intervention target for reducing alcohol-related harms.

The relationship between social anxiety and alcohol use in remand prisoners

Community studies have found a consistently high co-occurrence, between alcohol use and anxiety disorders, such as social phobia. Despite high prevalence rates of alcohol use and anxiety disorders in remand prisoners, the extent to which they co-occur in this population and the use of alcohol as a strategy to reduce social anxiety, have not been examined. The aim of this study was to assess levels of social phobia and the use of alcohol to reduce anxiety associated with social and performance situations in a remanded prison population. One hundred and one male prisoners (age M = 34.88 years, SD = 11.70) participated in the study. They completed the Social Phobia Inventory (SoPhI) and a questionnaire designed to assess levels of drinking in social and performance situations to reduce anxiety. High levels of social anxiety were found, together with high levels of drinking to reduce anxiety associated with social or performance situations. Drinking was predictive of reduced levels of social anxiety but the effect of social anxiety on drinking was stronger. The implications for treatment and future research are discussed.

Teaching teachers : building a post-compulsory education training and employment sector through teacher education

This paper captures development of the GDAL as understood by its instigators as a platform for reform. The GDAL would respond to the challenge being put before education and training providers to prepare young people to create and engage with a learning society through their capacity for lifelong learning. These teacher education students would, ideally, bring skills and knowledge already gained in a professional career. While they would gain teacher registration they were better conceptualized as professional educators for an emerging post compulsory education, training and employment sector: it was expected that graduates would not only teach in schools but would also move readily within the network of learning spaces that young people increasingly experience in their formal education. In the process, they would be a force for change, seeding reform within secondary schools. As a 'teacher' these graduates would have the credibility to challenge the entrenched practices of other teachers. It is the story of 'what happened' as a consequence of this specific aim that I am telling today.

Flexible delivery in the Australian vocational education and training sector: Barrier to success identified in cases studies of four adult learners

Government policy in Australia is increasingly encouraging training organisations in the Vocational Education and Training (VET) sector to adopt flexible delivery approaches, but some researchers are sounding a note of caution. Evidence is emerging that Australian VET learners are not universally ready for flexible delivery, and this is reflected in high attrition rates and low pass rates. The literature on flexible delivery identifies a number of specific factors that can impact on the success of adult learners. However, there seems to be agreement that failure or dropout is not determined by a single factor, but by the interaction of a number of factors that build up over time. To understand these factors, we need to understand the learners - what their participation in education means to them, the context in which they are studying, and the numerous inter-connected factors that contribute to their failure to achieve a successful outcome. This paper discusses four case studies from a research project that followed up a small number of adult learners who enrolled in flexible delivery VET courses but did not achieve a successful outcome.

Issues in the implementation of cross-cultural management in Australia-evidence from a study of selected public and private sector organisations

This study examines the current status of cross-cultural management (CCM) in Australia.

The study is based on Reyes' (2004) Ph.D research of a qualitative nature in five organisations in the public and private sectors selected from a sample of organisations which appear to lead the field in Australia in respect of CCM. Literature is also surveyed to present a picture of the current legal and institutional setting of CCM in Australia and provide a context for the study.

Analysis of the findings highlights the gap between cross-cultural rhetoric and action in workplace situations. Problems are identified leading to incomplete and inadequate implementation of CCM in the respondent organisations. The study argues for the need for management to take a systems approach to the formulation and implementation of CCM. Some suggestions are made for improvements in the future.

Flexible delivery and student attrition in the vocational education and training sector: case studies of students who dropped out

Government policy in Australia is increasingly encouraging training organisations in the Vocational Education and Training (VET) sector to adopt flexible delivery approaches. This policy shift is supported by key VET stakeholders including Industry Training Advisory Boards. A recurring theme in VET policy documents is an apparent confidence that flexible delivery can meet the diverse needs of individual learners while at the same time providing cost savings. Yet evidence is emerging that Australian VET learners are not typically ready for flexible delivery, and this lack of readiness is reflected in high attrition rates and low pass rates in many flexibly delivered courses. One research project found that over 70% of learners in the Australian VET sector do not have the learning capabilities required to be ready for flexible delivery. A recent review of the module outcomes achieved by VET students nationally found that students studying by external/correspondence and self-paced unscheduled modes had lower module completion rates than students studying by other delivery strategies.

Research on student progress in flexible delivery within the Australian VET sector has largely been quantitative. That research provides useful statistical data on completion and attrition rates for various modes of delivery, but does not explore the reasons underlying the high attrition rates found in flexible delivery. The qualitative research that is available tends to focus on students who successfully complete their courses, not on those who withdraw. As a result, the Australian literature on flexible delivery in the VET sector is lacking in-depth qualitative information about students who enrol in courses but do not complete. In comparison, the broader literature on distance education and flexible delivery in other educational sectors offers some useful insights into student attrition, and can be can be used to inform research into attrition within the Australian VET sector.

This paper reports on aspects of a research project that followed up six adult learners who enrolled in VET courses but who either failed assessment or withdrew. The research project presented the students’ stories in the form of narrative case studies, focussing on the detailed examination of the barriers that each student experienced, and analysing these barriers in relation to issues raised in the literature. This paper reports on two particular themes that emerged from that research project. The literature on distance education and flexible delivery argues that:


· student dropout is often not determined by a single factor, but by the interaction of a number of factors that build up over time;

· students who experience difficulties when studying by flexible delivery can often be reluctant to access the support that is available to them.

This paper uses these themes as a point of reference in presenting the stories of some of the students who participated in the research project.

Cross-sector organisational engagement with ethics : a comparison between private sector companies and public sector entities of Sweden

Purpose – The purpose of the paper is to describe and compare similarities as well as differences in the organizational engagement with ethics between private sector companies and public sector entities.

Design/methodology/approach – A survey was conducted in order to examine the organizational engagement with ethics in the largest private sector companies and the largest public sector entities in Sweden. Two adapted questionnaires were developed for each sector. The outcome of this research procedure is reported in this paper.

Findings – There are both minor and major differences between the private sector and public sectors, where the private sector companies overall tend to be more engaged with ethics than the public sector entities in areas such as: ethical bodies, ethical tools, internal and external ethical usage, and ethical support measures and ethical performance measures.

Research limitations/implications – This paper makes a contribution to theory as it outlines findings for the benefit of other researchers working in private and/or public sectors in the field. A suggestion for further research is to examine the organizational engagement with ethics in other countries/cultures that differ from the ones in this research effort performed in the private and public sectors of Sweden.

Practical implications – The research may be of managerial interest as it provides a grounded framework of areas to be considered in the examination of organizational engagement with ethics in both private sector companies and public sector entities. It may be used as a benchmark by either sector.

Originality/value – It reports a research effort to develop and describe a cross-sector comparison of the organizational engagement with ethics between private sector companies and public sector entities of Sweden. A framework is also introduced and illustrated. It also makes a contribution to theory and practice in the field as it is based upon a dual sample that provides insight into cross-sector organizational engagement with ethics.

Ethical, economic and efficient sector : is it a gamble? The case of New Zealand Health

The New Zealand public sector has gone through major reform as a result of fiscal deficit in 1984 (KettI, 1997; Schwartz, 1997), resulting in shift of emphasis from quality service provision to establishing financial supremacy (Kettl, 1997). This raises concern as to how public sector employees are attaining balance between their service objectives with financial ones and how is the ethics negotiated in this process. Following this concern, this paper focuses on determining the organisational variables consisting of organisational policies in the District Health Boards (DHBs) and hospitals of New Zealand on ethical behaviours of managers and the ethical climate of these departments. The aim of this study is to increase our understanding of the ethical climate of the public health. Our findings suggest that little emphasis has been provided to the aspect of ethics in New Zealand health sector. There is no reward for employees who exhibit exemplary ethical behaviour, no hot line to consult/report about ethics, any detailed guidelines and policies, and not enough ethics-related training provided to staff.

Evaluation of a community-based mental health drug and alcohol nurse in the care of people living with HIV/AIDS

There is a growing need for advanced practice mental health and drug and alcohol nursing roles in the care of people living with HIV/AIDS; however, limited publications address these domains. This study evaluated a community-based mental health drug and alcohol nurse role caring for people living with HIV/AIDS (Mental Health D&A Nurse) in a large not-for-profit district nursing organization providing care to people living with HIV/AIDS in an Australian city. Outcomes from a client assessment and 6–8-week follow-up by the Mental Health D&A Nurse are presented as captured by the Depression Anxiety Stress Scales (DASS 21), Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Health of the Nation Outcome Scales (HONOS) and WHOQoL BREF. Mean scores and caseness were analysed, and significant differences were found on the 'impairment' and 'social problems' subscales of the HONOS. Results of semi-structured interviews with clients describe effective and supportive mental health care and health-promoting education following visits by the Mental Health D&A Nurse. These positive findings support continuing implementation of the role within this community setting and indicate that even greater benefits will ensue as the role develops further. Findings are of interest to clinicians and policy makers seeking to implement similar roles in community-based HIV/AIDS care.